PayPal Payment Form 2018 MEMBER APPRECIATION PARTY

SOUTHERN CALIFORNIA MG CLUB KICK-OFF-NEW-YEAR-PARTY RESERVATION
JANUARY 13, 2018 12:30 PM

Les Freres Taix Restaurant 1911 W. Sunset Blvd. Los Angeles, CA 91350
Cost Per Person: $39

Please fill in the names and food choices below.
Driver Name*

First NameLast Name
E-mail address*
1. Coq au Vin Chicken2. Roast Top Sirloin3. Fresh Boneless Trout Almandine4. Special Dietary Needs Upon Request. Please list below.
Please list additional guest names below and their meal choices.
Co-Driver Name
Meal Choice for Co-Driver 1
Type Number
Additional Attendee 1 Name
Meal Choice for Attendee 1
Type Number
Additional Attendee 2 Name
Meal Choice for Attendee 2
Type Number
Select Total Number In Your RSVP that will be attending in the Dropdown.*
prevnext( X )
Driver$39.00

Total People Attending

Total $0.00
Click the button below to be directed to PayPal for payment.
Should be Empty:

JANUARY 13, 2018 12:30 PM